轉變病患行動能力佈署：以台灣透析病患團體行動為例

Transforming the Deployment of Patients' Agency: A Case Study of Dialysis Patients' Organizations in Taiwan

為探討台灣腎友會對病患行動能力的影響，本研究提出「行動能力佈署」概念，並追問病患行動能力構成與轉化的議題。本研究在Michel Foucault與行動者網絡理論啟發下，以佈署觀點探討行動能力構成。本研究指出台灣腎友會面對透析醫療體制時，所發展的十種行動類型，對（希望）改變病患處境，呈現協助、補充、轉化、對抗、創新等策略意涵。這些行動表現對病患個體生存能力、制度性能力、道德能力、知識與選擇能力的影響。最後，佈署觀點並不是要回答腎友會「能」或「不能」為病患增能，或病患是否有行動能力的議題，而是期望更為細緻地探討病患行動能力構成的時空形構、轉化與穩定過程。除了在此展示的透析病患案例外，行動能力佈署概念也將有助於理解社會行動者自我轉化的經驗，以及社會體制轉變的實務與理論思考。

This paper explores the possibility of theorizing the multitude of Taiwanese dialysis patients' organizations' actions and various impacts. Drawing from the deployment perspective of Michel Foucault and Actor-Network theory, this paper proposes the concept of 'deployment of agency' to articulate the constitution and transformation of patients' agency in these actions. Following the deployment perspective, the organizations' ten types of action are specified as 'assistive,' 'supplementary,' 'transforming,' 'antagonizing,' and 'innovative' strategies in terms of their relations to the dialysis regime, which (intend to) interfere with the constitution of patients' agency in terms of its subsistence, institution, identity, and knowledge aspects. This paper also argues that agency is more than a 'yes or no' or 'enabling or not' issue. The concept of deployment of agency proposes to portray the temporal and spatial configurations, transformation, and stabilization of agency. Apart from specifying patients' situations, this concept might be a plausible candidate for enhancing our practical and theoretical understandings of the self-transformation of social actors and the competing deployments of social regimes.